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PubMed1989

[Recurrent dislocation of the hip prosthesis].

Recurrent dislocation of a hip prothesis is a severe complication. For the patient it is debilitating both physically and mentally. In most such cases one or more revision operations are necessary. Reintervention is more likely to be successful if the cause and the mechanism of luxation are understood. Recurrent hip dislocation is often seen after insertion of socalled tumor prostheses, after the "southern" approach and in the case of fracture treatment. One helpful and secure method seems to be the conversion of a non-linked prosthesis to a linked prosthesis. For elderly patients the simplest method seems to be cementing the head of a bipolar hip prosthesis.

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Incidence of dislocation following hip arthroplasty for patients in the rehabilitation setting.

Dislocation of a hip arthroplasty prosthesis is the most common serious complication after hip replacement. It is especially important in the rehabilitation setting because it is potentially preventable. The purpose of this study was to investigate differences in dislocation rates between rehabilitation and acute hospital settings. A retrospective chart review of total hip and bipolar hemiarthroplasty patients admitted to three rehabilitation hospitals was performed. Dislocation rates among 825 rehabilitation patients who met study eligibility criteria were compared with rates found among 5352 acute care patients reported in the published literature. The rate of hip dislocation among total hip replacement patients in rehabilitation hospitals was not significantly higher than that in acute settings (2.17% v 1.27%). Among bipolar hemiarthroplasty patients, however, the dislocation rate was markedly and significantly lower in rehabilitation than in acute settings (0% v 1.95%, P < 0.01). Possible reasons for these results are discussed. Further research is needed to identify risk factors more precisely for prosthesis dislocation.

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